Young Adults With Cancer Are Prone to Experience Severe Financial Toxicity

Immense financial challenges confront young adults with cancer. As a result of medical bills and the loss of savings, these patients may forgo recommended medications and/or follow-up appointments. More dialogue between health care providers and young adults may empower these patients and steer them toward reputable sources of financial support.1

“We had a vast repository of program data from the past several years, and we knew this was an important story to tell because of the lack of a spotlight on young adults facing financial toxicity," said Michelle Landwehr, MPH, chief operating officer at The Samfund in Boston, Masschusetts, and lead author of the study. The Samfund is a national nonprofit that supports young adult cancer survivors in the United States as they recover from the financial impact of cancer treatment. Landwehr stated that studies specifically addressing the financial strains on young adults with cancer are rare.

“We hear all the time from young adult survivors who have told us, anecdotally, that the subject of cost never even came up with their doctors; oftentimes they cope by completely ignoring the topic or otherwise they stress about it all the way through their treatment and long after, which is the last thing they need,” Landwehr said. A study out of Duke Cancer Institute also suggested a link between financial distress and higher mortality rates.

The finances of young adult cancer survivors are devastatingly impacted by cancer in an age-specific way, according to this study. In addition to the cost of medication, hospital bills, co-pays, and related treatment necessities, young adults are particularly affected by their station in life: they may have student loans, no established credit, and have no health benefits from jobs that they may have just started, if they are working at all. Oftentimes, this population has had to stop work while undergoing treatment and has no income, while their bills continue to pile up and multiply. Given their age and life stage, they likely lack parental support but have not yet established significant savings of their own.

"We found that financial indicators of young adult cancer survivors are worse than their healthy peers in many domains. Further, young adult survivors in their 30s report more perilous prefunding financial situations than younger grant recipients, who may be covered by their parents' insurance policies," said senior author Rebecca Johnson, MD, of Mary Bridge Children's Hospital/MultiCare, Seattle, Washington.

This study involved a retrospective analysis of data collected from Samfund grant applications of 334 young adult cancer survivors. Grants were awarded between 2007 and 2013 and grant recipients were consented electronically in 2014 for retrospective data analysis. They ranged in age from 17 to 39 years at the time of their grant applications. Descriptive statistics were calculated and compared to the Medical Expenditure Panel Survey and US census data on age-matched peers.

The financial impact of cancer was found to be more severe in young adults ages 30 to 39 years compared with those younger than 30 years. The researchers stated that older young adults are more likely to marry and receive additional income through a partner, but they are also less likely to receive parental assistance and more likely to have dependent children and homeownership than the younger age group.